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Healing of burn wounds by topical treatment: A randomized controlled comparison between silver sulfadiazine and nano-crystalline silver

Author(s): Abhishek Adhya, Jayanta Bain, Oindri Ray, Avijit Hazra, Souvik Adhikari, Gouranga Dutta, Sudhin Ray, Bijay Kumar Majumdar

Background: Silver sulfadiazine (SSD) has been the standard topical antimicrobial for burn wounds for decades. Recently, nanometerâ�?�?�?�?sized silver particles are available which have high surface to volume ratio and remain effective even at a very low concentration and minimizes the chance for tissue toxicity due to silver. Hence, we conducted a randomized controlled trial to compare the effectiveness of topical SSD and nanoâ�?�?�?�?crystalline silver (AgNP) hydrogel in burn wounds management. Materials and Methods: Study was conducted in the Burn Unit of IPGME&R; & SSKM Hospital Calcutta, from January 2011 to August 2012. Patients with 2° burn injury were randomly allocated to SSD and AgNP treatment group. Clinical assessments of burn wound were done on every week till 4th week and on completion of treatment. Results: Data for evaluation were obtained for 54 patients on SSD (2° deepâ�?�?�?�?dermal cases 27) and 52 (2° deepâ�?�?�?�?dermal cases 31) on AgNP treatment. Healing status of 2° deepâ�?�?�?�?dermal burns was more satisfactory for AgNP group than SSD treatment at 4 weeks. Among patients receiving AgNP, 80.6% showed at least 50% healing of 2° deepâ�?�?�?�?dermal wounds compared to 48.1% on SSD at 4 weeks (P = 0.001). The figures for complete healing at 4 weeks were, respectively, 4% and 0% (P = 0.116). Conclusions: AgNP can be an effective and superior alternative to SSD for burn wounds, particularly 2° deepâ�?�?�?�?dermal burns. Healing can be expected, in general, in 6 to 8 weeks time, depending upon the extent of body surface involvement.

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